Efficacy of Group-Based Peer Support with Active Duty Military Spouses: A Randomized Controlled Trial of the Reach Program

Background and Purpose: Active-duty military spouses face unique stressors due to the highly uncertain nature of the military lifestyle. Common challenges include barriers to the pursuit of career and educational goals, relationship stressors, mental health concerns, lack of social support, and financial strain. Though these challenges are common among military spouses, few evidence-based preventative programs exist to address them. REACH (Resource Empower Advocate Connect Heart) aims to improve participants’ mental health and social support outcomes; it consists of weekly two-hour, in-person group peer support sessions led by trained military spouse peer facilitators over eight weeks. Each week features a topic related to common challenges, with peer-led facilitated discussion using a sem-structure curriculum with other military spouses around their shared lived experiences. Session content is tailored to the military experience, providing educational content and information about local and national supports related to each sessions’ topic. A randomized controlled trial was conducted to evaluate the effects of participation in a REACH group on quality of life, mental health and social support. Methods: Virtual focus groups with Army spouses were initially conducted to tailor an established peer support group curriculum originally for veteran spouses to the Army spouse experience. Participants were then recruited from Fort Hood, Texas (n = 98), and randomized to the active or waitlist condition. Assessments were administered immediately after randomization, at session completion (week 8), and three months post-program. Outcomes of interest included quality of life (Q-LES-Q-SF), depression (PHQ-9), anxiety (GAD-7), social support (MOS-SSS), and self-care practices (MVSSCI) and knowledge of psychological health. Each week, participants were asked to complete a session feedback questionnaire (n=347), while leaders documented program fidelity (n=213). Repeated-measures MANOVA was conducted in R and SPSS. Thematic analysis of session questionnaires and fidelity checklists was completed in NVivo. Results: Multivariate analysis showed a significant group-by-time interaction (V = 0.07, F(2, 94) = 3.70, p = .028). Univariate analysis further revealed that active group participants had significantly greater improvements in quality of life than waitlist group participants did over time (F(2, 190) = 5.27, p = .006). This pattern of improvement was also observed with depression, (F(2, 190) = 3.77, p = .025), self-care (F(2, 190) = 4.20, p = .016), and psychological health knowledge (F(2, 190) = 5.63, p = .004) when comparing the active group to the waitlist group over time. Thematic analysis showed that participants most enjoyed feeling a sense of community (47.3%) and the educational content (32.3%) of the REACH program. Leaders reported high program fidelity (50.2%) but did suggest changes to curricula for session timing (11.7%). Conclusions and Implications: This study provides evidence for peer support delivered as an 8-week, group-based weekly program on improvements in military spouses’ mental health, self-care, and knowledge related to relevant health issues. Tailored, peer-led support for military spouses is an effective way to support military spouses facing common challenges experienced during military life. Further research should explore broader implementaiton and scalability of REACH to other military installations and long-term maintenance of outcomes.